What Is Mobile Therapy and Is It Effective?

mobile therapyMobile therapy is a relatively new concept involving the use of smartphones or text messaging to deliver treatment for certain psychological conditions.

Through wearable tech and digital apps such as mood trackers, coaching programs, and connected monitors, people can use mobile therapy to successfully manage anxiety, grow resilience, and get more in tune with their happiness.

So, how does mobile therapy work, and what does it involve? Read on to learn more about the pros and cons of this increasingly popular direction in positive psychology and find out whether it’s for you.

What Is Mobile Therapy? A Definition

Mobile therapy broadly refers to the use of mobile communication technologies, such as smartphone applications, instant messaging services, and SMS, to provide mental health services (Moore, 2019).

Irrespective of the specific technologies used, mobile therapy is founded on the premise that mobile communication technologies can help us track and improve our wellbeing (Morris et al., 2010). Such technologies are also increasingly providing a channel for therapists to deliver interventions and educational materials to their clients as part of a blended care approach to conducting therapy.

While mobile therapy can be conducted in many ways, the proliferating number of mobile therapy apps have tended to use these technologies for three purposes (Morris & Aguilera, 2012):

  • Emotional monitoring;
  • Therapist-patient communications; or
  • Self-paced Learning.

 

Emotional monitoring apps

Quenza ReflectionMany mobile apps aim to strengthen users’ awareness of their fluctuating emotional states and triggers in the environment that drive these affective experiences and subsequent behaviors.

To achieve this, such apps employ an experience sampling methodology (ESM) to allow users to report on their emotional experiences, thoughts, and behaviors at randomized or scheduled intervals.

Among their various functions, some blended care apps, such as Quenza (pictured here), enable therapists to design brief reflections that clients can complete at several points throughout their day.

Patterns in the data and possible interventions can then be discussed with the client at their next in-person session with the therapist.

The impetus for this modern approach to mobile therapy appears to stem from work by Mihaly Csikszentmihalyi examining fluctuations in the flow experience (1987; 2008).

During the late ’80s, when Csikszentmihalyi and Larson were studying the flow experience, their key interest was how participants felt at different points throughout the day (Farnworth et al., 1996). Having given each person a pager, they then sent questions at random intervals, asking them about their experiences and behaviors.

For example: “What was the primary thing you were doing when you got this message?

Over time, they compiled this data to build a more integrated picture of the events that were related to participants’ subjective experiences – what actions or contexts were related to flow, and different patterns in people’s positive flow experiences.

The data collected through these ESM studies facilitated research and provided useful information for participants looking to cultivate more positive emotions and the experience of flow.

 

 

Therapist-patient communications apps

We live in a busy age. While patients and therapists can’t always be face-to-face, mobile therapy’s premise is that we can still constructively maintain a clinical relationship with a professional and continue to receive treatment with the aid of our smartphones.

Therapist-patient communication features are included in some mobile apps so that professionals can deliver support and advice throughout the day, while patients are not in the clinic. They may, in other cases, connect the user to an online support community where they can receive advice or chat with others when encountering difficulties.

Talkspace is one example of a mobile therapy app that links users to trained, licensed counselors for a monthly fee.

 

Apps for self-paced learning

Quenza learningSelf-paced learning is increasingly becoming a cornerstone of mobile therapy interventions.

Many modern apps designed for individuals and therapists use a combination of text, multimedia, and digital activities (e.g., surveys) to help therapy clients learn new psychological frameworks and practice helpful interventions.

Such apps can be indispensable in a therapeutic context and help to keep clients mindful and engaged in between therapy sessions. They are also highly customizable, enabling therapists to deliver personalized treatments based on a patient’s unique needs. By using an app like Quenza, therapists can design pathways of self-paced learning activities that clients can complete outside the therapy room and in their own time.

This sort of blended care approach has the advantage of freeing up more time during face-to-face sessions and allows clients to proceed with their learning at a pace that best suits them.

For individuals looking for science-backed psychology resources, another useful app is Live Happy by Dr. Sonja Lyubomirsky. This app offers a range of proven tips and ideas to help you live a more meaningful life through interviews with positive psychology and wellbeing thought leaders.

 

How Does Mobile Therapy Work?

Mention “mobile therapy” and dedicated self-help apps are likely the first thing that springs to mind. But clinical tools aren’t the only way consumers can access treatment if they’re looking to supplement conventional sessions with a therapist.

Mobile therapy, it’s been argued, can encompass everything from social networks and wearable tech with smart sensors. As we’ve looked a little bit already at mobile apps, let’s consider some alternatives.

 

Social media

Easily accessible on the go through mobile apps, researchers Morris and Aguilera (2012) argue that social media can be viewed as psychological interventions. Looking at sites such as Facebook, Twitter, and LinkedIn, they argue that social media offer social connectedness, helping users cope with social isolation, loneliness, and associated negative affect.

It’s this psychosocial advantage, the authors premise, that benefits users in the form of online support groups, forums, and discussions – helping individuals spread positive affect, build up social capital, and form friendships with one another (Ellison et al., 2007; Burke et al., 2011).

On top of this, social media gives users access to positive inspiration from role models, shared information, and advice. In groups where individuals can share their feelings and receive help from others, they can learn from others with whom they have shared values, friends, and experiences (Morris & Aguilera, 2012).

 

Disadvantages of social media

Of course, every rose has its thorns – most of us are far from unfamiliar with the potential psychological risks of social media (Vogel et al., 2014):

Psychosocial damage can result from unhelpful social comparisons – “Look how great Angel’s career is doing compared to mine…”. Negative self-evaluations and fear of negative evaluation from others contribute to distress and worsen symptoms of social anxiety – arguably having a damaging, rather than therapeutic psychological effect (Wolniewicz et al., 2018).

Social networking sites are sometimes also blamed for social isolation, an effect that first gained popularity with the controversial Internet Paradox Study by Kraut and colleagues (1998). Simply put, the authors found evidence to suggest that as participants’ internet usage increased, they communicated less with those immediately around them. It is also worth noting that this study has been criticized elsewhere in the literature – you can find a full reference at the end of this article.

 

Wearable tech

A more passive approach to mobile therapy involves data collection from sensors, which a user wears while awake or asleep (Morris & Aguilera, 2012). As with a fitness tracking device – such as the well-known FitBit – wearable therapy tech can involve watches, sensors, or similar to collect physiological or geographical data (Fletcher et al., 2011).

By gathering information on a user’s mood or well-being, a connected app can send individuals an intervention message at certain times, or they may prompt them to carry out a quick assessment.

Advice or support might fall under the Cognitive Behavioral Therapy (CBT) framework at the more clinical end of the scale, or they may be as simple as a friendly reminder to check in for a positive affirmation.

 

Disadvantages of wearable tech

As increasingly more apps are released on the market, researchers and practitioners are warning consumers against relying too heavily – or solely – on wearable tech to improve their mental health.

One common criticism, offered by Morris and Aguilera (2012) is that it can be difficult for the user to differentiate between quality sensors and low-cost, unreliable technology. Rather than helping practitioners or clients, they argue, low-caliber wearables may simply be that – cheap and frustrating.

 

Is it Effective?

There is some meta-analytic research to suggest that mobile health apps can be effective mental health interventions. Looking at randomized controlled trials – the “gold standard” of research methodologies (Hariton & Locascio, 2018), Chandrashekar (2018) found the following:

Mobile therapy app users with mild to moderate depression benefited from a reduction in depressive symptoms in comparison to control research participants – the apps they used were designed to help them self-manage their symptoms (Firth et al., 2017);

Anxiety-focused apps helped people with sub-clinical anxiety symptoms by decreasing their total anxiety – although, the positive impact was greatest when mobile therapy was combined with e-therapy or in-person treatment (Ly et al., 2015);

By targeting behavioral symptoms, mobile apps which focused on schizophrenia were related to a range of mental health benefits, while managing to retain users and deliver a positive, engaging experience.

 

What makes a mobile therapy app effective?

Quenza Telepsychology ExampleAs with any application, mobile apps designed to deliver therapy must be designed such that users stay intrinsically motivated to engage with them.

Features that can facilitate this engagement can include gamification, real-time interactions, and push notification reminders.

It is through the full utilization of these modern technologies and UX features that the benefits of mobile therapy can be realized.

The flip side of drawing on mobile technologies is that they often allow therapists to track their clients’ progress and engagement. This may, in itself, provide useful information to the therapist, such as hints as to a client’s level of motivation regarding their therapy.

Apps like Quenza facilitate this real-time feedback for therapists, allowing therapists to track clients’ progression easily through any designated activities or self-paced learning pathways.

Such apps may also help clients who need extra support to remember to complete digital activities. As Christopher & MacDonald (2005) point out, depression and mood disorders such as anxiety can take a toll on working memory. Therefore, an intuitive app with the option to send push notification reminders can provide additional support for clients who struggle to remember to complete assigned homework or activities.

Other useful app features can support users with self-awareness and self-monitoring (Heron & Smyth, 2010), such as journaling apps, virtual diaries, and mood trackers.

 

5 Mobile Therapy Apps To Try

Looking to try out some apps for yourself? These are some well-known smartphone applications that might interest you:

 

1. Quenza

Quenza LogoAs shown throughout this post, Quenza is a user-friendly, blended care software solution designed to help therapists, counselors, and telepsychologists leverage their clients’ personal communication devices to deliver mental health solutions.

No matter your therapeutic approach, Quenza features a range of tools to help you prepare activities, assessments, learning modules and more, all customized to your specific service offerings.

Alternatively, if you’re short on time, you can pick and choose from Quenza’s ever-growing library of pre-loaded science-based interventions and assessments.

Once done, you can then send your activities directly to your client, who completes them directly on their smartphone, tablet, or computer.

Quenza features a HIPAA-compliant portal, facilitating safe and secure engagement with exercises and psychoeducational content. Meanwhile, you as the therapist can remain updated on your clients’ progress through activities from your own computer or handheld device.

Whether you’re a solo practitioner or a large coaching organization, Quenza provides a range of price packages to suit any business size and is currently offering a 1-month trial for just $1 to let you try out the platform for yourself with zero risk.

 

2. Talkspace Online Therapy

Talkspace is a paid interactive app that matches users and licensed therapists through chat, journaling, or even video chat. When you sign up, you’re paired with a personal counselor who will respond one or two times each day.

In between responses, you’re encouraged to write messages about anything which you feel is relevant to your therapy, whether that’s PTSD, stress, anxiety, or trauma.

Try the Talkspace app.

 

3. Track Your Happiness

We mentioned Track Your Happiness earlier – it’s part of a Harvard research initiative. This app aims to help users understand what contributes to their happiness with experience sampling techniques.

Answer a few starter questions (because it’s a research project, it will use your demographic information) and respond to regular prompts that look at key happiness variables. For example – what you’re doing, whether you need to be doing it, when you’re happy, and so forth.

Try the Track Your Happiness app.

 

4. SuperBetter

Want to build your resilience through an app? This gamified application invites you to complete activities or quests to receive power-ups and progress – each activity is a scientific way to improve your resilience.

Designed by Dr. Jane McGonigal, it offers a more engaging experience than text-based courses. Expect to be challenged to resilience training activities: to hug yourself, exercise, and other activities that help target challenges, depression, and more.

Try the Superbetter app.

 

5. Mindshift

Mostly designed for treating anxiety, this app encourages users to check-in and describe their anxiety in a few clicks. Based on a CBT framework, it provides tools to help users challenge their thinking, tackle in-the-moment stress or panic, and reorient around positive action.

You’ll also find guided meditations, space to journal, and advice on tackling stressful situations in a better way.

Get Mindshift for Android or at the App Store.

 

A Take-Home Message

Hopefully, you have a better idea of the many ways that apps, wearable tech, and social media are being used to improve mental health, and their many potential uses in positive psychology. If you’re interested in finding out more about how mobile therapy might benefit you personally or professionally, why not share your thoughts with us?

Or, ask us your questions – we’d love to hear from you in the comments below.

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  • Chandrashekar, P. (2018). Do mental health mobile apps work: evidence and recommendations for designing high-efficacy mental health mobile apps. Mhealth, 4.
  • Christopher, G., & MacDonald, J. (2005). The impact of clinical depression on working memory. Cognitive neuropsychiatry, 10(5), 379-399.
  • Csikszentmihalyi, M., & Larson, R. (2014). Validity and reliability of the experience-sampling method. In Flow and the foundations of positive psychology (pp. 35-54). Springer, Dordrecht.
  • Csikszentmihalyi, M. (1987). Das flow-Erlebnis: jenseits von Angst und Langeweile: Im Tun aufgehen. Berlin: Klett-Cotta.
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  • Farnworth, L., Mostert, E., Harrison, S., & Worrell, D. (1996). “The experience sampling method: Its potential use in occupational therapy research.” Occupational Therapy International 3, no. 1: 1-17.
  • Firth, J., Torous, J., Nicholas, J., Carney, R., Pratap, A., Rosenbaum, S., & Sarris, J. (2017). The efficacy of smartphone‐based mental health interventions for depressive symptoms: a meta‐analysis of randomized controlled trials. World Psychiatry, 16(3), 287-298.
  • Fletcher, R. R., Tam, S., Omojola, O., Redemske, R., & Kwan, J. (2011, January). Wearable sensor platform and mobile application for use in cognitive behavioral therapy for drug addiction and PTSD. In 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society (pp. 1802-1805). IEEE.
  • Hariton, E., & Locascio, J. J. (2018). Randomised controlled trials—the gold standard for effectiveness research. BJOG: an international journal of obstetrics and gynaecology, 125(13), 1716.
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  • Kraut, R., Patterson, M., Lundmark, V., et al. (1998). Internet paradox: a social technology that reduces social involvement and psychological well-being. American Psychologist, 53, 1017–1031.
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  • Morris, M. E., Kathawala, Q., Leen, T. K., Gorenstein, E. E., Guilak, F., DeLeeuw, W., & Labhard, M. (2010). Mobile therapy: case study evaluations of a cell phone application for emotional self-awareness. Journal of medical Internet research, 12(2), e10.
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  • Wolniewicz, C. A., Tiamiyu, M. F., Weeks, J. W., & Elhai, J. D. (2018). Problematic smartphone use and relations with negative affect, fear of missing out, and fear of negative and positive evaluation. Psychiatry Research, 262, 618–623.

About the Author

Catherine Moore has a BSc in Psychology from the University of Melbourne. She enjoys researching and using her HR knowledge to write about Positive and Organizational psychology. When she isn’t getting super ‘psyched’ about her favorite topics of creativity, motivation, engagement, learning, and happiness, she loves to surf and travel.

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